Date:
Department:
Room #:
Name:
Title:
Campus/Building:
KEY REQUEST: Full Time Employee:
Office Move
Lost Key
ACCESS CARD:
New Employee
Office Move Lost Card
Facilities or Public Safety Department will verify this request with employee’s immediate supervisor.
Keys / Access Cards are the property of Massachusetts Bay Community College. The College reserves the
right to change locks and/or keys at any time with advance notification to key holders. Lost keys / access
cards must be reported immediately to Campus Police and the Facilities Dept.
Upon termination of employment with the College I agree to return all keys / access cards that have been
issued to me.
I have read and understand the above statements and by submitting the form I agree to adhere to the above conditions.
Key Location: (i.e. room #, desk, filing cabinet, etc.)
Access Card Location: (i.e. room #, desk, filing cabinet, etc.)
SUBMIT
MASSBAY COMMUNITY COLLEGE
KEY / ACCESS CARD REQUEST FORM
MassBay policy does not provide part-time employees with keys.
